TAMPA Fla. (Reuters) - A
painful, mosquito-borne viral illness has surfaced
across the United States, carried by recent travelers to
the Caribbean where the virus is raging.

Health officials in North Carolina, Nebraska and Indiana this week
reported the first confirmed chikungunya cases in those states,
along with Tennessee, which has suspected cases.

Chikungunya has rapidly spread in the Caribbean in recent months,
sending thousands of patients to hospitals with painful joints,
pounding headaches and spiking fevers.

Florida's 25 cases account for the majority reported in the United
States, according to state health officials and the U.S. Centers for
Disease Control and Prevention.

The cases in the continental United States have not been transmitted
by local mosquitoes, which would raise the threat.

"It will be more difficult for the virus to establish itself here,"
said Dr. William Schaffner, an infectious disease specialist at
Vanderbilt University Medical Center in Nashville, Tennessee.

Along with new reports, the CDC is monitoring chikungunya in
Arkansas, California, Connecticut, Maryland, Minnesota, Nevada, New
York, Virginia, Puerto Rico and the U.S. Virgin Islands.

Symptoms surface within three to seven days after a bite from an
infected mosquito and typically dissipate within a week. There is no
vaccine, and the virus is not deadly. Medications can help treat
high fevers.

The Caribbean Public Health Agency said this week the number of
confirmed and suspected cases had risen to 135,651, up from just
over 100,000 on June 2. The virus has been detected in 20 countries
and territories, with the largest outbreak of suspected cases in the
Dominican Republic.

Health officials in the Dominican Republic said they detected more
than 77,000 suspected cases since the virus reached the country five
and half months ago, including 20,000 new suspected cases in the
last week alone, according to the Public Health Ministry.

World Health Organization representatives in Haiti said chikungunya
will continue to spread as mosquitoes breed in standing water and in
the open containers used in many Haitian homes that lack running
water.

(Additional reporting by Ezra Fieser in Santo Domingo; Editing by
Colleen Jenkins and Will Dunham)